Notes

Osteoclasts accommodate physioxia perturbation via Genetic make-up demethylation.
The former patients of the service (49%) were twice as numerous among people ≥60 years old (57% vs 30% in those under 60 years). The readmission rate was 19% (29% for men versus 8% for women). The mean length of stay was 7 ± 5.7 days. The transfer rates and hospital mortality were 11.3% and 1.2%, respectively.

The morbidity diagnosed at the Internal Medicine department of the Msaken regional hospital was dominated by the triad acute bronchitis, diabetes mellitus and erysipelas, particularly in the elderly. Hence the need to strengthen the training of future family doctors in pulmonology, diabetology and infectious diseases.
The morbidity diagnosed at the Internal Medicine department of the Msaken regional hospital was dominated by the triad acute bronchitis, diabetes mellitus and erysipelas, particularly in the elderly. Hence the need to strengthen the training of future family doctors in pulmonology, diabetology and infectious diseases.
Health system reforms in many countries have shown that the delivery of integrated primary health care services according to family medicine is the most efficient approach to achieve universal health coverage. In Tunisia, the issue is therefore the capacity of our health system to integrate a care approach based on family practice.

To assess the preparedness to implement family medicine in our country Methodology this is a qualitative study carried out over a period of 9 months during the year 2017.Based on a WHO protocol addressing the 13 pillars of family practice, our study explores health policy context, actors (using interviews with key informants at national, regional and local level) and health content.

Family practice model is a strategic priority in Tunisia. However, this political recognition suffers from a lack of operationalization, in relation with continuing medical training, registration of patients and families by doctors, referral system, minimum package of essential care/ essential drugs and quality of care monitoring as well as community involvement..

Our situation analysis reveals that the delivery of integrated care based on family practice model; enforce to adopt a comprehensive and operational health policy that goes beyond the academic aspects.
Our situation analysis reveals that the delivery of integrated care based on family practice model; enforce to adopt a comprehensive and operational health policy that goes beyond the academic aspects.
The Basic Health Care Policy (BHC), the Maghrebian version of WHO's Primary Health Care, is celebrating forty years in Tunisia. The aim of this paper was to contribute to the evaluation of BHCs in Tunisia, by listening to the testimonies of experts / leaders who have led their journey during these four decades.

The experts / leaders included in this testimony were invited via email and throu gh the use of the Delphi technique to report the acquired lessons and the errors. The collected qualitative data was analyzed through a process of categorization which classified them into assets (strengths and opportunities) and handicaps (weaknesses and threats).

Four experts / leaders took part in this call for testimonies, including two consultants to international organizations, a trade union doctor and a professor of Preventive Medicine. The main assets of the BHC in Tunisia, according to the participants, were 1. The medical leadership initiated from the student phase; 2. The political commitment of public auunisia highlighted the perception of its performance "in tune" with WHO and "three years before Alma Ata". The new generation of BHC leaders have an obligation to safeguard their principles and adapt their practices to population expectations and new managerial approaches.
Describe the training needs of young Maghreb doctors in epidemic management.

This is a study to quantify the need for medical training on "epidemic management". The study population was formed by residents and assistant professors of the French-speaking faculties of medicine in the Greater Maghreb, hospital-university professors, who were invited to respond to an online questionnaire. The "need" for learning a skill was defined by the perception of its importance, of its low coverage by the curricula and its poor mastery. A grid with 20 items, coded according to the Likert scale of 1 to 5 points, was specially developed for the measurement of need, retained beyond the thresholds of 45/90 points for the two dimensions "confirmation" and "investigation", 60/120 points for the "control" dimension, and 150/300 for the total sum.

A total of 121 young Maghreb doctors answered the questionnaire to assess the needs for learning epidemic management skills. The median overall scores for the chapters "importance", "coverage" and "performance" were 76, 40 and 48 respectively out of 100 points. The median scores for training "needs" were 54/90, 48/90 and 67/120 points, respectively, for the dimensions "confirmation", "investment" and "control", giving a global median score of 168 / 300.

Capacity building in epidemic management is a need felt by young Maghreb doctors, partially covered by current medical school programs, and consequently altering their professional performance.
Capacity building in epidemic management is a need felt by young Maghreb doctors, partially covered by current medical school programs, and consequently altering their professional performance.The objective of primary health care is to reduce mortality and morbidity. Staurosporine solubility dmso This kind of care was very efficient in communicable diseases, malnutrition and maternal and neonatal diseases; however, their impact on non communicable diseases and mental disorders control is not obvious. In Tunisia, primary health care was introduced in the early 1980s; a lot of progress were notified in particular in health of mothers and children in particular, but only slightly in non communicable diseases control and mental health promotion. Therefore, a new approach would be strongly recommended to remedy this situation. The Medical Periodic Check-up (MPC) implemented in North America would have a positive impact in the prevention and management of non communicable diseases. What would be the place of this MPC in primary health care in Tunisia? The MPC has two main objectives the prevention of specific diseases and health promotion. However, despite its efficiency and usefulness, the MPC could be costly, especially for countries with limited resources.
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